The possibility of the nerve sparing surgery in various groups of patients with cancer of the rectum.
N.N.Petrov Research Oncology Institute, St.-Petersburg
City Oncology Center, St.-Petersburg
Purpose: Rectal cancer surgery is impaired by a high rate of postoperative urinary and sexual dysfunction cause with frequent autonomic nerve injuries. The aim of this study was prospective evaluation of possibility of pelvic nerve preservation in various groups of the patients with rectal cancer and determination of indications for nerve sparing surgery.
Methods: One hundred eighty seven patients with adenocarcinoma of the rectum underwent autonomic nerve preserving surgery. Age, gender, tumor localization, T-stage, kind of surgical procedure, preoperative radiotherapy and intraoperative complications were analyzed in relationship with the volume of pelvic nerve preservation.
Results: The total preservation of pelvic autonomic nerves was achieved in 68.5%, partial preservation in 16.0%, no nerve preservation in 15.5%. Such factors as tumor localization, T-stage, type of surgical procedure, preoperative radiotherapy and intraoperative complications had major or minor influence on possibility of pelvic nerve preservation procedure.
Conclusion: Pelvic nerve preservation technique can be used in all cases of rectal cancer surgery except true tumor invasion in pelvic nerves and life-threatened intraoperative complications.